Supporting a Brighter, More Rested and Refreshed Under Eye Appearance
The tear trough is the hollow or groove that runs from the inner corner of the eye downward along the junction between the lower eyelid and the cheek. When this area becomes hollow, shadowed or sunken — creating a darkened, tired or aged appearance beneath the eye — it is referred to as a tear trough deformity, and it is one of the most commonly sought aesthetic concerns in cosmetic medicine.
For many people, a pronounced tear trough creates a persistently tired, sad or aged appearance around the eyes that no amount of sleep, concealer or skincare can fully address. The tear trough area is one of the most structurally complex and delicate regions of the face — and understanding its anatomy and the specific contributors to hollowing in each individual is essential to achieving a safe, natural and genuinely transformative result.
At Symmetry Cosmetic Clinic, we take a highly personalised, anatomically considered and conservative approach to tear trough treatment. The under eye area demands the highest level of clinical skill, careful assessment and precise treatment technique — and our focus is always on achieving a result that looks naturally refreshed and rested rather than obviously treated or overdone.
Whether you have noticed tear trough hollowing developing gradually with age, have always had a naturally prominent tear trough or are experiencing a combination of under eye concerns, a personalised consultation allows us to assess your anatomy and develop an individualised treatment plan aligned with your goals.
The tear trough is a complex anatomical structure influenced by multiple tissue layers simultaneously. Understanding the specific contributors to tear trough hollowing in each individual is fundamental to developing a safe and effective treatment approach.
The tear trough forms at the junction between the lower eyelid and the cheek — an area where the orbital fat of the lower eyelid meets the underlying bone of the orbital rim and cheek. In youth, this transition is smooth and gradual — the lower eyelid blends seamlessly into the cheek without a visible groove or shadow. As the face ages and changes, this smooth transition becomes disrupted — creating the hollowed, shadowed groove that characterises a pronounced tear trough.
One of the primary contributors to tear trough hollowing is the loss of volume in the periorbital and mid-cheek area that occurs with age. As the fat pads of the lower eyelid and cheek diminish and descend, the support beneath the tear trough region is reduced — creating a hollowed appearance and a visible groove at the lid-cheek junction. Restoring lost volume in this area with carefully placed dermal filler is the most direct and effective treatment for volume-related tear trough hollowing
The bones of the orbital rim and midface undergo resorption and remodelling with age — reducing in volume and causing the overlying soft tissue to lose structural support. As the orbital rim becomes more prominent relative to the surrounding tissue, the tear trough groove becomes more defined and the transition between the eyelid and cheek more abrupt and shadowed. In some individuals, a naturally prominent orbital rim contributes to a tear trough appearance even in youth — independent of volume loss.
The skin of the lower eyelid and tear trough area is among the thinnest on the entire body — making it particularly susceptible to the effects of volume loss, collagen decline and the visible presence of underlying structures. As the skin thins with age and collagen declines, the hollowing of the tear trough becomes more visible and the dark shadowing more pronounced — even in the absence of significant volume loss.
In some individuals, true pigmentation or the visibility of underlying blood vessels through the thin lower eyelid skin contributes to the darkened appearance of the tear trough area. This pigmentary or vascular component can coexist with structural hollowing and may influence the treatment approach — as filler alone may not fully address a darkened appearance that has a significant pigmentary or vascular driver.
Tear trough prominence is strongly influenced by genetics and individual facial anatomy. Some people develop a visible tear trough in their twenties or even earlier — not as a result of ageing but as a natural feature of their facial structure, orbital anatomy and skin quality. For these individuals, earlier treatment can be particularly beneficial in maintaining a rested and refreshed under eye appearance over time.
The tear trough is one of the most technically demanding areas of the face to treat with dermal filler — requiring precise placement, appropriate product selection and a conservative approach to volume that prioritises a natural result above all else. Overfilling the tear trough is one of the most common complications in this area and can create a puffy, unnatural or Tyndall effect appearance that is difficult to correct. A thorough assessment and a careful, conservative treatment philosophy are non-negotiable in this region.
Your consultation begins with a detailed assessment of your tear trough anatomy — including the degree of hollowing, the prominence of the orbital rim, the quality and thickness of the lower eyelid skin, the presence of lower eyelid fat prolapse, the contribution of pigmentation or vascularity to the under eye appearance and the overall volume and contour of the mid-cheek area. We take the time to carefully evaluate your individual anatomy and concerns to ensure treatment is appropriate, safe and likely to deliver a natural and genuinely refreshed result.
Based on your assessment, a customised treatment plan is developed. Tear trough treatment is not appropriate for every individual — in some cases, the anatomy of the lower eyelid or the degree of fat prolapse present may mean that alternative or complementary approaches are more appropriate than filler alone. Where filler is indicated, product selection, placement depth and volume are carefully tailored to your individual anatomy to ensure the most natural and safe result.
Selected treatments are performed according to your individual treatment plan, with the aim of restoring volume and support to the tear trough area, reducing hollowing and shadowing beneath the eye, improving the smoothness of the lid-cheek junction and achieving a naturally brighter, more rested and refreshed under eye appearance.
Tear trough filler typically provides results that last for a meaningful period of time, though the duration varies between individuals depending on the product used, the degree of volume restoration required and individual metabolism. We provide continued support, treatment reviews and recommendations to help maintain your results and monitor the under eye area over time.
Tear trough hollowing is primarily driven by volume loss, fat pad descent, skeletal changes and skin thinning in the delicate periorbital area. Effective treatment requires a thorough anatomical assessment and a carefully considered, conservative approach to volume restoration that prioritises natural-looking results and the highest standards of safety.
At Symmetry Cosmetic Clinic, treatment for tear troughs most commonly centres on precisely placed dermal filler to restore volume and support to the tear trough area and improve the smoothness of the lid-cheek junction. Depending on individual anatomy and concerns, this may be complemented by the Glass Facial, bio-remodelling, Rejuran skin rejuvenation, LED light therapy, signature facials and medical-grade skincare programs to improve the quality, hydration and overall appearance of the delicate under eye skin and support the overall rejuvenation result.
Our goal is to restore a naturally brighter, smoother and more rested appearance to the tear trough and under eye area — achieving a result that looks genuinely refreshed rather than obviously treated and that is in complete harmony with your individual facial anatomy and features.
